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1.
Laryngoscope Investig Otolaryngol ; 7(2): 627-635, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35434329

RESUMO

Objective: The aim of this systematic review and meta-analysis was to investigate the association between obstructive sleep apnea (OSA) and erythrocytosis. Methods: The PubMed, Web of Science, and Cochrane Library databases were searched for articles examining hematocrit values in patients with OSA and control individuals published till September 1, 2021. The pooled standardized mean difference (SMD) with 95% confidence interval (CI) was calculated, and subgroup analyses were performed. Results: Eleven eligible studies with a total of 4608 patients with OSA were included in this meta-analysis. Pooled outcomes revealed that hematocrit values were significantly higher in patients with OSA than in controls (SMD, 0.19; 95% CI, 0.08-0.29; p < .01). When studies were stratified by disease severity, the significant differences in hematocrit values between patients and controls were only observed in the severe OSA group (SMD, 0.34; 95% CI, 0.08-0.59; p < .01), but not in the mild and moderate OSA groups. In subgroup analyses according to sex and publication year, significant differences in hematocrit values between patients and controls remained stable in studies with only female patients (SMD, 0.25; 95% CI, 0.12-0.38; p < .01) and in studies published after 2012 (SMD, 0.17; 95% CI, 0.06-0.28, p < .01). Conclusion: Our meta-analysis revealed that the hematocrit value was significantly increased in patients with OSA, particularly in severe patients, compared with that in controls. However, the elevation was modest, and the hematocrit value is expected to be within the normal range in patients with OSA. These data suggest that OSA leads to slight increases in hematocrit but does not cause clinically significant erythrocytosis.

2.
Dermatol Ther ; : e15459, 2022 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-35304935

RESUMO

To investigate the efficacy and safety of combined treatment with a serum comprising a micro-diamond suspension and micro-gold cage with a 1064 nm picosecond neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for facial skin rejuvenation. Topical serum was applied to the entire face and allowed to penetrate the skin and hair follicles for 20 min. Each participant was then treated with a 1064 nm picosecond Nd:YAG laser on the face. Photographs of each participant were taken at baseline, immediately after treatment, and 2 weeks after treatment using an imaging tool (Mark-Vu®; PSI PLUS, Suwon, Republic of Korea). Global improvement scores by two blinded investigators and participants' satisfaction scores were also assessed. The melanin index (MI), transepidermal water loss (TEWL), and skin hydration were evaluated using a device. Parameters associated with skin rejuvenation were assessed using Mark-Vu®. Adverse events were observed and reported by participants and physicians during the treatment and follow-up visit. At week 2, 40% (4/10) of the participants showed more than moderate clinical improvement in the investigator's global improvement assessment. No significant differences were observed in the MI, TEWL, skin hydration level, or skin parameters of Mark-Vu®. At week 2, 40% of the participants reported a high satisfaction score and minimal side effects. The novel topical facial serum comprising micro-diamond suspension and micro-gold cage is safe and effective when combined with laser treatment for facial rejuvenation.

3.
Clin Otolaryngol ; 47(1): 167-173, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725914

RESUMO

OBJECTIVE: To investigate the association between physician-diagnosed diabetes mellitus (DM) and chronic rhinosinusitis (CRS) phenotypes in a national population-based study. STUDY DESIGN: Retrospective cross-sectional study. SETTING: Population-based survey data were collected by the Korean National Health and Nutrition Survey between January 2008 and December 2012. PARTICIPANTS AND METHODS: A total of 34 670 participants aged over 19 years were enrolled in the Korea National Health and Nutrition Examination Surveys from 2008 to 2012. The relationship of CRS prevalence, with and without nasal polyps, with physician-diagnosed DM and non-DM were assessed. Differences in sinonasal symptoms between patients with and without DM were analysed in this cross-sectional study. RESULTS: A significant association was observed between DM and CRS with nasal polyps after adjustment for multiple variables. No substantial association was observed between DM and CRS without nasal polyps. Among patients with CRS, olfactory dysfunction for >3 months was significantly more frequent in the DM group than in the non-DM group. CONCLUSION: We demonstrated significant associations between DM and CRS with nasal polyps and olfactory dysfunction among patients with CRS in a large national clinical cohort study. The direct mechanism of the association between DM and CRS with nasal polyps should be further investigated to clarify the pathogenesis of CRS with nasal polyps.


Assuntos
Complicações do Diabetes , Pólipos Nasais/complicações , Transtornos do Olfato/etiologia , Rinite/etiologia , Sinusite/etiologia , Adulto , Doença Crônica , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , República da Coreia , Estudos Retrospectivos
4.
Eur Arch Otorhinolaryngol ; 279(2): 793-800, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33959804

RESUMO

PURPOSE: The serum galactomannan test has been used for diagnosing acute invasive fungal sinusitis (AIFS), especially invasive Aspergillus. We aimed to assess the accuracy of the test to diagnose acute invasive Aspergillus sinusitis (AIAS). METHODS: We searched all relevant articles published in PubMed, Embase, the Cochrane Library, and Web of Science databases up until September 14, 2020. The available data for serum galactomannan test to diagnose AIAS from selected studies were assessed. The diagnostic odds ratio (DOR), summary receiver operating characteristics (SROC), sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were estimated. Additionally, we analysed four studies with a cut-off value of 0.5. RESULTS: Five eligible articles were selected in this study. The total number of enrolled patients was 118, and 62 patients had confirmed AIAS. Among these 62 patients, the summary estimates of the serum galactomannan assay were as follows: DOR, 3.37 (95% confidence interval [CI]: 1.47-6.66); sensitivity, 0.63 (95% CI 0.50-0.74); specificity, 0.65 (95% CI 0.51-0.76); PLR, 1.83 (95% CI 1.21-2.74); NLR, 0.58 (95% CI 0.39-0.83). The SROC was 0.68. CONCLUSION: In this current meta-analysis, the serum galactomannan test was classified as less accurate for purposes of diagnosing confirmed AIAS. These results suggest that the initial diagnosis of AIAS should not solely be dependent upon serum galactomannan test results. More studies of the test are needed in patients with AIAS to more accurately assess its diagnostic value.


Assuntos
Mananas , Sinusite , Aspergillus , Galactose/análogos & derivados , Humanos , Sensibilidade e Especificidade
5.
J Plast Reconstr Aesthet Surg ; 75(4): 1447-1454, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34955393

RESUMO

BACKGROUND: Among the materials used for dorsal augmentation rhinoplasty (DAR), cross-linked human acellular dermal matrix (ADM) has been claimed for its low risk of infection and extrusion. The aim of this study was to compare the effectiveness of ADM in subjects undergoing primary versus revision dorsal augmentation rhinoplasties. METHODS: Using a retrospective cohort study design, the investigators enrolled a cohort set of DAR patients operated by a single surgeon during a 65-month interval. The predictor variable was the treatment group (primary or revision DAR). The main outcome variables were postoperative changes with regard to the degree of augmentation (ratio of the dorsal height [DH] and radix height [RH] to the nasal length) and patients' and surgeons' satisfaction with the aesthetic and functional results. Other study variables were grouped into the following categories: demographic, surgical, and pathological. Descriptive, uni-, and bivariate statistics were computed using P ≤ 0.05 as a cutoff value. RESULTS: The study cohort comprised 145 subjects (75.2% with primary DAR; 39.3% females) with a mean age of 30.7 ±â€¯9.4 years (range, 19-58). DAR was linked to the significant changes in DH and RH in both the treatment groups. Comparison of the two groups revealed that there was no significant difference in DH and RH between both the groups. Surgeons' and patients' satisfaction rates were comparable between the two surgery groups, neither of which experienced serious complications. Microscopic findings of the removed ADM showed abundant collagen tissue with newly formed vessels without signs of foreign body reaction. CONCLUSION: Despite significant differences in patient characteristics (age; number of osteotomy, tip plasty, and hump reduction surgeries), the results of this study suggest that ADM can be used in both primary and revision DAR, with minimal complications.


Assuntos
Derme Acelular , Rinoplastia , Adulto , Feminino , Humanos , Masculino , Nariz/cirurgia , Reoperação/métodos , Estudos Retrospectivos , Rinoplastia/métodos , Resultado do Tratamento , Adulto Jovem
6.
Ann Otol Rhinol Laryngol ; 131(1): 71-77, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33870717

RESUMO

OBJECTIVES: Several allergy tests are used for the diagnosis of allergic rhinitis; however, few studies have reported a direct comparison of the skin prick test (SPT), multiple allergen simultaneous test (MAST), and ImmunoCAP according to specific allergens. This study aimed to evaluate the correlations between each test and allergic rhinitis symptoms and to evaluate the correlations of the MAST and ImmunoCAP with the SPT for representative indoor allergens in Korea. METHODS: Electronic medical charts were retrospectively reviewed, and 698 patients with allergic rhinitis who had performed SPT, MAST, and ImmunoCAP were enrolled. Correlations between each allergy test for 4 representative indoor allergens and the symptoms of allergic rhinitis were analyzed. Agreements of the MAST and ImmunoCAP with the SPT were compared according to each allergen. RESULTS: The SPT showed higher correlations with allergic rhinitis symptoms for 4 indoor allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat, and dog allergens) than the MAST or ImmunoCAP. In comparison between the MAST and SPT, the least correlation was observed for the dog allergen, whereas between the ImmunoCAP and SPT, the least correlation was observed for the cat allergen. The correlation between the ImmunoCAP and SPT was higher than that between the MAST and SPT for the dog allergen, whereas no significant differences were noted for other allergens. CONCLUSIONS: Overall, the SPT showed a higher correlation with allergic rhinitis symptoms than the MAST or ImmunoCAP for 4 indoor allergens. ImmunoCAP showed similar reactivity to MAST; however, it showed better positivity with dog allergen in patients who were reactive to the allergen in the SPT. Care should be taken while evaluating dog allergen sensitization using the MAST.


Assuntos
Alérgenos/imunologia , Rinite Alérgica/diagnóstico , Rinite Alérgica/imunologia , Testes Cutâneos , Adulto , Idoso , Animais , Correlação de Dados , Feminino , Humanos , Testes Imunológicos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
7.
Arch Craniofac Surg ; 22(5): 232-238, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34732034

RESUMO

BACKGROUND: Galeal or temporalis muscle flaps have been traditionally used to reconstruct skull base defects after tumor removal. Unfortunately, these flaps do not provide sufficient vascularized tissue for a dural seal in extensive defects. This study describes the successful coverage of large skull base defects using anterolateral thigh (ALT) free flaps. METHODS: This retrospective study included five patients who underwent skull base surgery between June 2018 and June 2021. Reconstruction was performed using an ALT free flap to cover defects that included the intracranial space and extended to the frontal sinus and cribriform plate. RESULTS: There were no major complications, such as ascending infections or cerebrospinal leakage. Postoperative magnetic resonance imaging showed that the flaps were well-maintained in all patients. CONCLUSION: Successful reconstruction was performed using ALT free flaps for large anterior skull base defects. In conclusion, the ALT free flap is an effective option for preventing communication between the nasal cavity and the intracranial space.

8.
Clin Exp Otorhinolaryngol ; 14(3): 249-250, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34407368
9.
Front Psychiatry ; 12: 685445, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34295275

RESUMO

Experiences of infectious diseases cause stressful and traumatic life events, hence, coronavirus disease 2019 (COVID-19) patients could suffer from various mental health problems requiring psychological support services. This study investigates the severity of mental health problems among confirmed COVID-19 patients. From March to November 2020, we collected the data from 118 COVID-19 patients who voluntarily participated in the National Center for Disaster Trauma's online mental health assessment consisting of self-report scales like Primary Care of Posttraumatic Stress Disorder screen (PC-PTSD), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Patient Health Questionnaire-15 (PHQ-15), and P4 Suicidality Screener. For control, 116 other disaster-experienced and 386 non-COVID-19-experienced participants were recruited. The COVID-19 patients showed more severe symptoms including post-traumatic symptoms, depression, anxiety, and somatic symptoms than control groups across all four screening scales (p < 0.001). Regarding high-risk, COVID-19 patients had an increased association with high-risk compared to the comparison groups (PC-PTSD: OR = 24.16, 95% CI = 13.52-43.16 p < 0.001; PHQ-9: OR = 14.45, 95% CI = 8.29-25.19, p < 0.001; GAD-7: OR=20.71, 95% CI = 10.74-39.96, p < 0.001; PHQ-15: OR = 5.65, 95% CI = 3.44-9.25, p < 0.001; P4: OR = 14.67, 95% CI = 8.95-25.07, p < 0.001). This study's results imply that there is a high-risk of overall mental health problems, especially stronger associations of post-traumatic stress symptoms, in COVID-19 patients. These findings help inform practitioners about the psychological responses to COVID-19 experiences and to prepare appropriate interventions and services for the incremental number of confirmed cases.

10.
Artigo em Inglês | MEDLINE | ID: mdl-34246214

RESUMO

BACKGROUND: The efficacy of rupatadine for the treatment of AR has been confirmed in numerous clinical studies, however there are very few studies on asian patients. OBJECTIVE: To assess the safety and efficacy of rupatadine fumarate in the treatment of Korean perennial allergic rhinitis (PAR) patients. METHODS: A multicenter, double-blind, randomized, placebo-controlled, comparative study of rupatadine fumarate and bepotastine besilate was conducted. Each group was administered rupatadine, bepotastine or placebo for 4 weeks. Primary parameters for efficacy included morning and evening symptom reduction from baseline at 4 weeks. Treatment safety and tolerability were evaluated according to a self-reported incidence and type of adverse events at each follow up visit. RESULTS: Rupatadine showed a significant reduction in symptoms at morning and evening evaluations, in both 5TSS (-5.69, P < 0.0006) and 4NTSS (-4.74, P < 0.0015) compared to placebo. There was a significant reduction from baseline for 5TSS (-65.4%, P = 0.002) and 4NTSS (-63.7%, P = 0.003) with rupatadine compared with placebo. At evening evaluations, there were significant reductions of 5TSS (-63.2%, P = 0.009) and 4NTSS (-61.6%, P = 0.013) for the rupatadine group. Compared with bepotastine, rupatadine showed greater reduction in the morning symptoms at 4 weeks. When individual symptoms were assessed with 12-hour reflective mean daily symptom score, rupatadine showed better efficacy than placebo in sneezing (P = 0.016) and rhinorrhea (P = 0.097). The rate of adverse events showed no statistical significance. CONCLUSIONS: Rupatadine is a safe and effective treatment option for Korean PAR patients and possibly a better choice over bepotastine for controlling morning symptom.

11.
Ear Nose Throat J ; : 1455613211012906, 2021 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-34121478

RESUMO

OBJECTIVES: Olfactory dysfunction, a reduced or complete loss of the ability to smell, is gaining attention because of its substantial impact on an individual's quality of life and the possibility that it is an important sign of underlying disease. However, olfactory dysfunction is underdiagnosed in the general population due to diagnostic difficulty and unpredictable prognosis. This study aimed to evaluate the prevalence of clinically diagnosed olfactory dysfunction in South Korea by using well-organized, nationwide, population-based cohort data, and the associations between olfactory dysfunction and risk of neurodegenerative disorders. METHODS: We investigated the Korean National Health Insurance Service-National Sample Cohort for patients diagnosed with olfactory dysfunction according to the International Classification of Diseases. Annual and overall incidence and prevalence of olfactory dysfunction during 2003 to 2013 and patient characteristics were analyzed. Based on those identified patients who were later diagnosed with neurodegenerative disorder, hazard ratios (HRs) of sociodemographic factors and comorbidities associated with neurodegenerative disorder were evaluated using a Cox proportional hazard regression model. RESULTS: In total, 6296 patients were clinically diagnosed with olfactory dysfunction during the study period (524.67 patients/year). The prevalence increased annually and was higher in female patients. The incidence of neurodegenerative disorders among patients with olfactory dysfunction was 4.2% within the study period. Multivariate cox regression analysis of the patients (n = 249) revealed that diabetes mellitus (HR = 1.976) and depression (HR = 2.758) were significant risk factors. CONCLUSIONS: Olfactory dysfunction is underdiagnosed in South Korea, but it is clinically important considering the possibility of presymptom of neurodegenerative disorders. In clinical practice, we should consider its association with neurodegenerative disorders and possibly other systemic conditions.

12.
BMJ Open ; 11(5): e047230, 2021 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-34035104

RESUMO

OBJECTIVES: We performed a cross-sectional analysis of data from the nationwide Korea National Health and Nutrition Examination Survey to evaluate the association between obesity and chronic rhinosinusitis with nasal polyps (CRSwNP) or without nasal polyp (CRSsNP). DESIGN: Retrospective cross-sectional analysis of health survey data. SETTING: Voluntary survey of representative South Korean populations. PARTICIPANTS: In total, 32 384 individuals aged 19 years or older with available data on CRS and obesity were included. PRIMARY AND SECONDARY OUTCOME MEASURES: Diagnosis of CRSwNP or CRSsNP was performed by trained otolaryngologists through sinus endoscopy and surveys of medical history. General and central obesity was diagnosed using body mass index (BMI) and waist circumference (WC), respectively. METHODS: A multivariate logistic regression analysis was used to clarify the association between CRSwNP or CRSsNP and obesity according to BMI and WC. Non-obese individuals were recruited as controls. RESULTS: The prevalence of CRSwNP was higher in the general (OR, 1.438; 95% CI, 1.170 to 1.768; p<0.001) and central (OR, 1.251; 95% CI, 1.031 to 1.520; p=0.033) obesity groups than in the control group. Prevalence of CRSsNP was not correlated with obesity. In a logistic regression analysis, olfactory dysfunction (OR, 1.329; 95% CI, 1.137 to 1.553; p<0.001) and purulent discharge (OR, 1.383; 95% CI, 1.193 to 1.603; p<0.001) showed a higher incidence in the central obesity group than in the control group. CONCLUSIONS: We demonstrated an association between CRSwNP and general and central obesity. Further investigations on the mechanism underlying this correlation are necessary for an improved understanding of the pathogenesis of CRSwNP.


Assuntos
Pólipos Nasais , Rinite , Doença Crônica , Estudos Transversais , Humanos , Pólipos Nasais/complicações , Pólipos Nasais/epidemiologia , Inquéritos Nutricionais , Obesidade/complicações , Obesidade/epidemiologia , República da Coreia/epidemiologia , Estudos Retrospectivos , Rinite/epidemiologia
13.
Stem Cells ; 39(6): 750-760, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33529470

RESUMO

The LIF-JAK2-STAT3 pathway is the central signal transducer that maintains undifferentiated mouse embryonic stem cells (mESCs), which is achieved by the recruitment of activated STAT3 to the master pluripotency genes and activation of the gene transcriptions. It remains unclear, however, how the epigenetic status required for the master gene transcriptions is built into LIF-treated mESC cultures. In this study, Jak2, but not Stat3, in the LIF canonical pathway, establishes an open epigenetic status in the pluripotency gene promoter regions. Upon LIF activation, cytosolic JAK2 was translocalized into the nucleus of mESCs, and reduced DNA methylation (5mC levels) along with increasing DNA hydroxymethylation (5hmC) in the pluripotent gene (Nanog/Pou5f1) promoter regions. In addition, the repressive histone codes H3K9m3/H3K27m3 were reduced by JAK2. Activated JAK2 directly interacted with the core epigenetic enzymes TET1 and JMJD2, modulating its activity and promotes the DNA and histone demethylation, respectively. The JAK2 effects were attained by tyrosine phosphorylation on the epigenetic enzymes. The effects of JAK2 phosphorylation on the enzymes were diverse, but all were merged to the epigenetic signatures associated with open DNA/chromatin structures. Taken together, these results reveal a previously unrecognized epigenetic regulatory role of JAK2 as an important mediator of mESC maintenance.


Assuntos
Proteínas de Ligação a DNA/metabolismo , Histona Desmetilases/metabolismo , Janus Quinase 2/metabolismo , Fator Inibidor de Leucemia/farmacologia , Células-Tronco Embrionárias Murinas/efeitos dos fármacos , Proteínas Proto-Oncogênicas/metabolismo , Animais , Diferenciação Celular/fisiologia , Células Cultivadas , Cromatina/metabolismo , Proteínas de Ligação a DNA/efeitos dos fármacos , Regulação da Expressão Gênica/fisiologia , Histona Desmetilases/efeitos dos fármacos , Células-Tronco Pluripotentes Induzidas/metabolismo , Janus Quinase 2/efeitos dos fármacos , Fator Inibidor de Leucemia/metabolismo , Camundongos , Células-Tronco Embrionárias Murinas/metabolismo , Fosforilação , Proteínas Proto-Oncogênicas/efeitos dos fármacos
14.
Korean J Intern Med ; 36(5): 1146-1156, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33561336

RESUMO

BACKGROUND/AIMS: Weather and air pollution are associated with the exacerbation of respiratory diseases. We investigated patterns of medical care use according to meteorological factors and air pollution in patients with asthma or chronic obstructive pulmonary disease (COPD). METHODS: We analyzed the medical care utilization patterns of patients with asthma or COPD registered in the Korea Health Insurance Review and Assessment database for the period 2007 to 2013. The patterns were divided into hospitalization and emergency department (ED) use. RESULTS: The medical care use of patients with asthma or COPD increased when the mean temperature and relative humidity were lower, and the temperature difference and atmospheric pressure were greater. Medical care use increased with the concentrations of particulate matter and ozone. Among age groups, sensitivity to pollutants was greatest in patients aged ≥ 65 years. The effect of being elderly was greater for asthma than for COPD, with a higher hospitalization rate. ED utilization affected by environmental factors was significantly greater for females and hospitalization was significantly more common for males. CONCLUSION: Meteorological factors and air pollutants were shown to contribute to increased medical care utilization by patients with asthma and COPD, particularly elderly patients. The overall effect was greater for COPD, but the effect in elderly patients was greater for asthma. In addition, the patterns of change in medical care use due to environmental factors differed according to sex.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Asma , Doença Pulmonar Obstrutiva Crônica , Idoso , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Asma/diagnóstico , Asma/epidemiologia , Asma/terapia , Feminino , Hospitalização , Humanos , Masculino , Material Particulado , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/terapia
15.
J Craniomaxillofac Surg ; 49(8): 682-687, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33608199

RESUMO

By affecting the tongue position and oropharyngeal airway volume, torus mandibularis is an anatomical factor associated with obstructive sleep apnea (OSA). This study aimed to investigate the influence of torus mandibularis on the surgical outcomes of multilevel upper airway surgery with tongue base resection (TBR) in patients with OSA. Patients with OSA who underwent palatal surgery and TBR were retrospectively analyzed. The patients were divided into two groups according to the presence or absence of torus mandibularis upon physical examination or on computed tomography images. The anatomical characteristics of the upper airway and pre/postoperative polysomnography were analyzed. The control and torus mandibularis groups comprised 69 and 35 patients, respectively, with all of them showing improved sleep quality after surgery. Apnea-hypopnea index (AHI) scores decreased from 42.1 ± 22.2 preoperatively to 23.9 ± 21.4 postoperatively in the control group (p < 0.001), and from 45.2 ± 19.9 to 22.5 ± 13.5 in the torus mandibularis group (p < 0.001). Comparing the postoperative changes in AHI, the AHI of the torus mandibularis group improved by 22.7 ± 23.4, whereas that of the control group improved by 18.1 ± 19.6 (p = 0.296). Sleep efficiency improved from 90.0 ± 7.5 to 92.8 ± 6.8 in the control group, and from 90.3 ± 8.7 to 93.6 ± 6.5 in the torus mandibularis group; however, there was no statistical difference between the two groups (p = 0.816). The presence of torus mandibularis did not appear to significantly affect the surgical results in OSA patients, but it did elicit significant changes in polysomnographic parameters compared with the control group. Therefore, following the identification of torus mandibularis in OSA patients, TBR should be considered as part of planning, as it may help to predict surgical outcomes.


Assuntos
Apneia Obstrutiva do Sono , Língua , Glossectomia , Humanos , Polissonografia , Estudos Retrospectivos , Apneia Obstrutiva do Sono/cirurgia , Língua/diagnóstico por imagem , Língua/cirurgia , Resultado do Tratamento
16.
Eur Arch Otorhinolaryngol ; 278(8): 2829-2836, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33388975

RESUMO

BACKGROUND: Evidence is accumulating that Staphylococcus aureus plays an important role as a disease modifier in upper and lower airway disease. We aimed to assess the association of staphylococcal enterotoxins (SEs) with allergic multimorbidity as well as the severity of chronic rhinosinusitis. METHODS: We retrospectively reviewed the medical records of 97 subjects aged 6 years or older between March 2018 and June 2019 and analysed symptom scores, computed tomography scores, serum IgE levels to SEs, serum total and specific IgE levels to inhalant allergens. To evaluate eosinophilic chronic rhinosinusitis (ECRS), we used refractory ECRS score from the Japanese epidemiological survey. RESULTS: Of the 97 patients enrolled, 29 (29.9%) were non-sensitised, 33 (34.0%) were mono-sensitised, and 35 (36.1%) were poly-sensitised. Sensitisation to SEs was closely associated with poly-sensitisation to inhalant allergens. SE-sensitised participants had higher median values for total and specific IgE levels to inhalant allergens than did non-SE-sensitised participants. SE sensitisation was associated with allergic multimorbidity and severe allergic diseases, such as ECRS. CONCLUSIONS: This preliminary study suggested that sensitisation to SEs may play a role in the initiation of type-2 inflammatory responses, such as allergic rhinitis, ECRS, and allergic multimorbidity. Furthermore, sensitisation to SEs correlated with the severity of ECRS.


Assuntos
Hipersensibilidade , Rinite , Sinusite , Alérgenos , Doença Crônica , Enterotoxinas , Humanos , Imunoglobulina E , Estudos Retrospectivos , Rinite/diagnóstico , Rinite/epidemiologia , Sinusite/diagnóstico , Sinusite/epidemiologia
17.
Clin Sci (Lond) ; 135(3): 483-494, 2021 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-33458745

RESUMO

The function of high-mobility group box 1 (HMGB1) varies according to its location. However, the translocation mechanism behind HMGB1 remains unclear. We hypothesize that type 2 helper T cell (Th2) cytokines are involved in the translocation of HMGB1 in the upper airway epithelium. We investigated the mechanism behind HMGB1 translocation using Th2 cytokine stimulation and examined the clinical significance of HMGB1 translocation in allergic rhinitis (AR). Cytoplasmic and extracellular HMGB1 were increased in AR. Inhibiting HMGB1 translocation with glycyrrhizic acid (GA) decreased the level of antigen-specific immunoglobulin E (IgE), the degree of Periodic Acid-Schiff (PAS), and Sirius Red staining in the murine model. The in vivo reactive oxygen species (ROS) level in the nasal mucosa was higher in the mice with AR than in the controls. Th2 cytokine-induced up-regulation of the ROS and translocation of HMGB1 by Th2 cytokines was dependent on the generated ROS. The ROS level also increased in the murine model. We suggest that the Th2 cytokine-dual oxidase (DUOX)2-ROS-HMGB1 translocation axis is important in AR pathogenesis.


Assuntos
Oxidases Duais/metabolismo , Proteína HMGB1/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Rinite Alérgica/patologia , Adulto , Animais , Células Cultivadas , Citocinas/metabolismo , Modelos Animais de Doenças , Feminino , Humanos , Masculino , Camundongos Endogâmicos BALB C , Pessoa de Meia-Idade , Mucosa Nasal/metabolismo , Células Th2/metabolismo
18.
Artigo em Inglês | MEDLINE | ID: mdl-33461910

RESUMO

INTRODUCTION: Serum level of high-mobility group box 1 protein is reportedly correlated with the severity of obstructive sleep apnea. OBJECTIVE: We tried to evaluate the possibility of using the serum high-mobility group box 1 protein level as a biologic marker in obstructive sleep apnea patients. METHODS: We generated a chronic intermittent hypoxia murine model that reflected human obstructive sleep apnea. Obstructive sleep apnea patients who underwent polysomnography were prospectively enrolled. Serum samples were obtained from mice and obstructive sleep apnea patients, and the serum high-mobility group box1 protein level was measured by enzyme-linked immunosorbent assay. RESULTS: Serum high-mobility group box 1 protein level was 56.16 ±â€¯30.33 ng/mL in chronic intermittent hypoxia and 18.63 ±â€¯6.20 ng/mL in control mice (p < 0.05). The mean apnea-hypopnea index and respiratory disturbance index values of enrolled obstructive sleep apnea patients were 50.35 ±â€¯27.96 and 51.56 ±â€¯28.53, respectively, and the mean serum high-mobility group box 1 protein level was 30.13 ±â€¯19.97 ng/mL. The apnea-hypopnea index and respiratory disturbance index were not significantly correlated with the serum high-mobility group box 1 protein level (p > 0.05). Instead, this protein level was significantly correlated with lowest arterial oxygen concentration (SaO2) (p < 0.05). CONCLUSION: High-mobility group box 1 protein may be involved in the pathogenesis of obstructive sleep apnea, and the possibility of this protein being a useful biologic marker in obstructive sleep apnea should be further evaluated.

19.
J Allergy Clin Immunol ; 147(4): 1453-1463, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-32795589

RESUMO

BACKGROUND: The relationship between allergic and eosinophilic inflammation, either systemic or local, in allergic diseases remains unclear. OBJECTIVE: We performed combined genome-wide association study (GWAS) and epigenome-wide (EWAS) for atopy and tissue eosinophilia to identify both genetic and epigenetic signatures between systemic and local allergic inflammation, and to capture global patterns of gene regulation. METHODS: We included 126 subjects for atopy analysis and 147 for tissue eosinophilia analysis, as well as 18 normal nasal tissue samples. We identified differentially methylated positions (DMPs) and genes associated with atopy and tissue eosinophilia. Furthermore, we performed mendelian randomization analysis and penalized regression along with replication in an independent cohort. RESULTS: EWAS identified genes, including Musashi RNA binding protein 2 (MSI2), associated with atopy, which contained enriched DMPs that genetically affect atopy. A direct association was observed between MSI2 single-nucleotide polymorphisms and atopy, as was a causal effect of changes in MSI2 expression and methylation on atopy, which was replicated in a Costa Rican population. Regarding tissue eosinophilia, EWAS identified genes with enriched DMPs directly contributing to tissue eosinophilia at the gene level, including CAMK1D. The gene ontology terms of the identified genes for both phenotypes encompassed immune-related terms. CONCLUSION: EWAS combined with GWAS identified novel candidate genes, especially the methylation of MSI2, contributing to systemic allergic inflammation. Certain genes displayed a greater association with either systemic or local allergic inflammation; however, it is expected that a harmonized effect of these genes influences immune responses.


Assuntos
Eosinofilia/genética , Hipersensibilidade/genética , Proteínas de Ligação a RNA/genética , Adulto , Metilação de DNA , Epigênese Genética , Epigenoma , Feminino , Ontologia Genética , Estudo de Associação Genômica Ampla , Humanos , Inflamação/genética , Masculino , Pessoa de Meia-Idade , Mucosa Nasal , Polimorfismo de Nucleotídeo Único
20.
Eur Arch Otorhinolaryngol ; 278(1): 109-115, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32757038

RESUMO

OBJECTIVE: Blocking airflow into the sinonasal cavity after surgery may help to keep the cavity moist and thus decrease postoperative crusting. Here we investigated the efficacy of Rhino-Protect ointment following endoscopic sinus surgery (ESS). SUBJECTS AND METHODS: A total of 93 patients with chronic rhinosinusitis who underwent identical ESS were enrolled. After surgery, all patients were instructed to perform nasal saline irrigation and deliver a nasal spray to each nostril, then to apply Rhino-Protect ointment to one nostril only; the other nostril served as a control. Subjective symptoms, postoperative Lund-Kennedy (LK) endoscopic scores, and adverse reactions 14 and 28 days after treatment were evaluated. RESULTS: The Rhino-Protect ointment significantly reduced pain (p = 0.015 at 28 days), dryness (p = 0.009 at 14 days and p = 0.045 at 28 days), and crusting (p = 0.047 at 14 days), and was associated with significantly lower LK scores 14 and 28 days after treatment (p = 0.037 and p = 0.007, respectively). Statistically significant differences were noted in the LK edema subscore at 14 days (p = 0.043) and in LK crusting subscores at 14 and 28 days (p = 0.005 and p = 0.006, respectively). No patient reported any serious adverse event associated with Rhino-Protect use. CONCLUSION: Applying Rhino-Protect after ESS significantly reduced the formation of edema and crusts, leading to improving the patients' discomfort for pain, dryness, and crust.


Assuntos
Endoscopia/efeitos adversos , Pomadas/uso terapêutico , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Seios Paranasais/cirurgia , Sinusite/cirurgia , Adulto , Idoso , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Rinite/tratamento farmacológico , Rinite/cirurgia , Resultado do Tratamento
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